Book Reviews

This monograph results from an effort by the International Union Against Cancer to study prognostic factors related to cancer and to extend work on TNM classification. The second edition provides a framework for considerations of prognosis and prognostic factors and for application of the factors to clinical practice. This edition is designed to encompass the scope of work in the field, to stimulate study of prognostic factors, and bring these perspectives to workers in the field. The book is divided into two parts. Part A, Principles of Prognostic Factors, discusses the importance of prognosis in cancer medicine; prognostic factors, principles and application; statistical methods for the analysis of prognostic factors; evaluating studies of prognostic factors; tumor, hosts and environmental related factors; prognostic factors in cancer patients; psychosocial factors; and the role of prognosis in cancer research. Part B, relates to prognostic factors in specific cancers and is divided into cancers of the head and neck, digestive system, lung and pleura, bone and soft tissues, skin, breast, gynecological, urological, ophthalmologal, hematologic, brain, and pediatric. The section on digestive system tumors includes cancer of the esophagus, stomach, colorectum, hepatocellular and biliary organs, and pancreas. The 46 chapters are written by 86 contributors, all well recognized in their field of study. The contributors are international in scope. I found the book of interest for two reasons. The first is the very excellent discussion of prognostic factors in cancer medicine. As quoted by Hippocrates, “It is the best thing, in my opinion, for the physician to apply himself diligently to the art of foreknowing.” There are many factors and variables in establishing a prognosis, and such an effort is of great importance to the patient, the patient’s family, and the physician. I think with today’s high-tech medicine we may forget the importance of establishing a reasonable guess as to what the future holds for the patient. The introductory chapter in Section A discusses in detail scientific and other factors related to developing accuracy in prognostic judgment. There is an excellent dissertation on statistical and mathematical analysis. The study of outcomes prediction is a well-advanced field with its own body of knowledge. Section B describes the various types of cancers and develops information concerning prognostic factors related to these cancers. Over all, I recommend this book as an excellent and useful source of information. Most textbooks do not delve into the area of prognosis or give a detailed analysis of prognostic factors as related to the type of therapy, ie, radiation, surgery, and/or chemotherapy, as well as age of patient and environmental factors which influence the outcome of therapy.

Dr. Davis, tin the Fevtr of Walchertn. 410 age, and of ages to come, to be in possession of a recoH of the. Waicheren fever and its consequences, both with a view to trace its analogy with the fevers of the marches of Lincoln, Kent, and Essex, and to judge of the efficacy of certain remedies lor their removal. Sir John iVmgle and Cleghorn/have described the sympr toms and appearances of remitting and intermitting fevers with ac* curacy, but they are both defective in minutice, and, above all, in that very interesting and useful part, the dissections, which o'ir author presents Us with in a particular and general manner. In this interesting work, we have pleasure in saying that we discover skill, perspicuity of expression, and a spirit of investigation, which pursues its aim with energy. In it we moreover find many luminous views of several diseases arising out of the primary fever, and incidental remarks wheh reflect credit on the author's judgment and learning.
A work of the above description is much wanted, on account of the scantiness of our present information on the Waicheren fever, and the discordant statements hitherto given, leaving the philosophic mind but little reason to be satisfied, and affording it but little ground for reflection. We are glad that the ideas which the author imparts to his readers, do not appear to have carried him beyond the limits of his personal experience, which seems every where corrected by his own good sense and acute observation. Dr. D-is already known by his French work, on the diagnosis of deatb and precipitate bu.ial, a.id in the literary tforld by his History o?
The author begins this work with'an ample introduction on the Medical Topography of Zealand, and considers philosophically all the local and general causes which conspire to render the island of" Waicheren so insalubrious. " Much of the tendency to disease in Zealand, and in Waicheren, seems tu depend on local causes 011 ft* sea-line; for it has been confidently asserted by several writers, that there is a peculiar <?pec es of damp exhalation, whi~h rises from th<? slime and mud laying on the beach, during the recess of the tide, and which has been thought more liable to produce bail effects, (for moisture always debilitates the body, and disposes it to disease,) from some chemical causes supervening from the mixture of th$ drainings of the land with the salts Ifeposited on it, and,, perhaps, with a portion of that putrescent phosphoric matter, which is known at times to be copiously distributed over the stirrer of tog ocean." Many curious circumstances are noticed, whereby the unhealthy ness of the season may be detected, by observing the decrees of moisture beneath and upon the surface of the soil.

He shews,
(what few persons are inclined to deny) that bad water, exposure to inclemencies of the weather, fatigue, and moisture, all concur* red to predispose the t oops to fever, but that marsh miasmata were tiece-sary to call the disense into action. The unhealtbiness of the island of Waicheren, he evidences in the ?*a*tituUonai cha-^8 ^ ratter 420 Dr. Davis, on the Feter of Walcheren. Tacter of the inhabitants. " The general constitution of the adul* herei is that to which ancient physicians have given the nameof phlegmatic. The organization, in short, is feeble, the complexion sallow, the body bloated, and frequently anasarcous, and all the grand functions of life are weakly and incompletely performed. The women, like the men, have a natural weakness of constitution, and become old at an early period of life/' Here follows from the public documents, detailed reports of the sick, >heir state at Colchester and Ipswich, and a narrative of the author's appointment. He has seen the Same fever in some French troops at Argues Martes, and in Piedmont. We learn at the conclusion of the introduction, and in the two first sections, that the common type of the Walcheren intermittent, as it appeared in England, was the double tertian, and meet with some interesting inquiries into that, very important point, the appearance of the fever, posterior to the arrival of the sick on our own shores. The author conceives this to be rare. lie does not, however, deny that it may declare itself in individuals returned to England, who were well while abroad ; and admits that there is no fixed period for mar?h miasmata to operate on the system, of which the instances wherein the fever has not appeared till after the return of the troops to England, are proofs. " There is not that I know of, any particular and definite period for the reception of marsh exhalations into the system, and their action upon it. They have occasionally been found not to operate until weeks after the person has been exposed to their influence. There are.certain symptoms, 'which, were they accurately noticed, such as debility, an oppressio Virium, nausea, and head-ache, with which men were frequently seized before Hie fever appeared, indicative, in my opinion, of the difficult admission of the miasmata into the system, which seemed to await for some favorable change ; as that, for instance, occasioned by exposure or irregularity of any kind, that would favour their entrance into, and operation on it. Jn every instance of disease, as far as I could asceitain, that fell to my lot to inspect, remission or intermission of the fever more or less evident, occurred, and I was left ignorant of ihis, its true appearance and character, from the imperfect representation of the sick ; it was usually confirmed in the presence of those consequences which it is known invariably "to entail. Admitting, however, that the fcver had not, in every case, manifested itself in Walcheren, it merely proves, that with a predisposition existing after the application of (lie exciting cause, the constitution, under particular circumstances, had the power of suspending the action of miasmata for a time, but ultimately yielded to their influence when such a power ceased to act." The author proceeds to give a definition and explanation of the type of the fever; first observing, that it assumed the quotidian,, tertian, double tertian, quartan, and even remitting type ; of all these, the double tertian was the most common, frequently forming the anticipating and retarding intermittent, by the hastening or pron --w traction traction of the return of the exacerbations. 41 Sometimes a period; of the fever," he observes, " was regular, that is,, during the period there was but one paroxysm and one interval." Generally, however, he says, " instead of one paroxysm and one interval in each period, there were two intervals and two paroxysms, differing,r however, materially, as to the violence and duration of symptoms, the hours of invasion, time of decline, and termination." He men-, tions, " that this type variously anticipating and p stponing, gave a peculiar mixed character to the disease, rendering it anomalous in nature, and tedious to the practitioner to treat/' Hp remarks too, " that there was a variety of the disease, in which, on one day,, there were two paroxysms, and on another, only one, while in other species of the fever, there has appeared to be a constant succession of paroxysms, one beginning as 6oonas a preceding or.ehad ? ended." The author shews that the fever anticipated so much in. some cases, that so many hours were gained, as to give a new character to the type, and even to make it resemble remitting more than internetting fever. He dwells with great exactness on its irregular tendencies, and shews discernment in representing all the., varieties of the double tertian type. The author confirms the observation of Clark, Fordyce, and Clegho.ru, of the retarding paroxysm frequently failing to return in the night time, and of occupying again, in succession, the diurnal hours as before ; a circumstance that he thinks contributed to change and modify the type anew. , pl\ In the next place, the author enumerates the irregularities which occasioned the double tertian type to change its course, and to become confused. Amongst these, we Jind debility,. prolongation' of; the paroxysm, and visceral disease mentioned. He considers that; these were the principal causes of such accidents, and very rarely an inflammatory diathesis. When, however, this did prevail, its force seemed much directed against the viscera of the abdomen, constituting a disease which the ancients called assodes.
The following section is devoted to an investigation of particular phenomena. The author's observations on the pulse are ingenious, and contain an account of various distinctions in I he pulsations of the artery, which are applicable to the subject of fever in general.
The inferences he draws from the state of the brain, the tongue, the skin, the bowels, from external signs, and various phenomena, the secretions, &c. are all deserving of the highest consideration, and aid materially in forming a true prognosis. Tfie whole of these are interspersed with appropriate illustrations. In the pathological view of the fever, the author takes some pains to shew that through the medium of nervous agency, marsh miasmata may produce vascular derangement, and this, jat length, terminate in plethora of the venous system, which the author is inclined to believe is the cause ot the torpor that, precedes the exacerbation.
Ihatve* nous plethora seems to have its.origin in diminished nervous energy,j is rendered probable by the dejection of spirits, the loss of muspu-^ 6 g 3 Ur lar power, and the general debility which attend this fever in all it* stages; also by the tendency there is rn certain parts to be attacked with spasm when-this disease inclines to a fatal termination. Such appears to me to be the cause of congestion in those organs whose vascular system is almost wholly venous, and in which the circular tion is naturally slow, and liable to interruption." The author admits ibat torpor titay be also occasioned by debility but as he al-Wa';s f-und the ?fcneifts system turgid! with blood, at whatever period ot the fever the patient died, he conceives,this plenitude may* in its t' rn. become a> cause of torpor, and ultimately of a paroxysm. '1 he-ratio symptomatum is methodical and excellent.
'I he rredisj?o>ing, concurring, and exciting causes, occupy ano? ther section; after which. the treatment of the fever is noticed.
This, theauthor comprises principally under the head of tonic, purgative, and mercurv.l. We refer the reader to the numerous, remarks lie ha-s made on cold* affusion, tobacco, opiates, ligatures, emetics, bleeding, and'various other expedients,-to shorten the fit,r and render it le.-s violent. The-numerous, complications of the fever, ana its combination with-viscevah disease-, rendered bark a very ineffectual, nay, sometimes an injurious remedy. The author found there was no security against a relapse,, nor any hope indeed, of recover), but where mercury was had recourse to, and persisted in for a great length of timi*, until all induration, and vestige of visceral jdisea?e-were removed. He also considers the efficacy oi drastic purges so great, as even to rival the power of mercury in, fjiany instance^ Ujjon this subject, he observes, that " far from thinking that drastic purgatives proved!ultimately injurious,, by vouring relapses, as Ford)ce and Gregory the elder,, pretend: I have no hesitation*in saying, that when they were repeated at proper intervals, they not only diminished the tendency, to relapse, but? carried off the congestion of the abdominal viscera when other re-, raedies failed; and proved the most effectual preventive of dysentery, arising from chronic inflammation of the intestines, a state that first induced diarrhoea*, and always ended in that disease." He says too, Dr. Thornton's Family Herbal. the completion of this useful book, had a few plates been introduced, illustrative of the morbid anatomy.
It is impossible, in the narrow limits assigned to a review, to enter more fully into the merits of this work. Suffice it here to &ay, that the fever and its consequences are traced with care and accuracy, that we consider it a valuable acquisition to a medical library, and recommend the perusal of it to our readers. It seems calculated, like the works of Cleghorn and Sir John Pringle, to be particularly worthy the attention of military practitioners. The whole book is interspersed with illustrations, and contains more research than could haye been expected jn the short time {he author has had to compose it.
A new Family Herbal, or Popular Account of the Natures and Properties of the various Plants used in Medicine, Diet, and the Arts. By Robert Tiiornton, M. D. 8vo. pp. 888. London. Many doubts have arisen on the utility of popular works oi) medicine, and the subject has, at various times, undergone much discussion ; yet the question may still be considered as in a great ineasurc undecided. For our own part, we confess, we do not think a science which, of ajl others, requires the extensive exercise of the highest powers of the mind to attain, and the practical ap^ plication of which is admitted to be so difficult, can by any possir bility be communicated in a compendium. When men who devote their whole lives to the cultivation of medical science, and who possess a fair share of abilities, and who are not deficient in industry and application, so often fail in their attempts to discover the real nature of a disease, and are frequently foiled in their endeavours to remove it, how shall we expect sp difficult a task to be accompli-hed by a superficial acquaintance with a fpw genera} rule? ?which are founded in empiricism, and calculated rather to mislead, than to inform those who consult them ? While, however, there is such a propensity in mankind to quackery, and the practice of dabbling jn medicine is so prevalent, we should be glad to see it productive of the least possible mischief; and surely a step would be gained, if the deleterious metallic poisons, such as calomel and arsenic, were banished from domestic use, and the good Lady Bountifuls were again to be employed in culling simples for possgts and sovereign ointments. On this account we congratulate l}r. Thornton on the appearance of his book, which is calculated to inspire jn its readers, a taste for botanical pursuits, and to attract their attention to the medical virtues of the vegetable tribes, which have perhaps, especially our own indigenous plants, been too much overlooked and neglected, eyen by physicians themselves.
The work is dedicated to Dr. Duncan of Edinburgh, and we shall transcribe the following passage in the dedication, as in some degree explanatory of the nature ol it, and of the author's plan in the arrangement of his subject, u A desire to become acquainted with the virtues of plants seems to have been coeval with the first dawn of knowledge; but the figures contained hi the books treating of these subjects arc so inac-~ curate, and the descriptions so vague, credulous, and, in every sense, so gross and vulgar, that mistakes are unavoidable, and false properties were bestowed On the most common and trivial plants.
, " The Medical Botany of the ingenious and able Woodvillr cleared much rubbish from this Augaian stable, but the expensive mode of its publication deterred many practitioners, and families in general, from the purchase ; there was, therefore, wanted for general and ordinary use a.companion to your useful and perfect Pharmacopoeia. Nothing more was required than simply to tread in your foot steps, adding figures by such an artist as Bewick, and. correct descriptions, with the 'addition' of some general prescriptions, combining at the same time from all authors whatever related to the subject. This could not be accomplished in a pharmacopeia ; the present work, therefore, is presented to the world as a more complete and perfect herbal than has hitherto appeared ; and as intended to unite the various advantages that have been derived to Science from your ' Edinburgh New Dispensatory.' I take this opportunity, therefore, to acknowledge the source of much of my information, which I .would'not, indeed, disfigure by a change of words, but have generally transcribed from your work, so that considerable part of the merit which may be found in this Herbal must injustice be ascribed to your industry and intelligence ; and I hope and trust, that the very superior engravings of Bewick will render it in every respect a useful introduction to Pharmaceutical Science." Although the Doctor was unwilling to disfigure that portion of information he has transcribed from the Edinburgh Dispensatory, a change of words, we do not think that enclosing it by inverted commas would have had that effect; and his readers would thereby have been better enabled to distinguish what is his owh from what he has derived from that source. In many cases, perhaps in all, as the herbal is intended for a companion to the dispensatory, a reference to the latter book would have been preferaj ble to a long quotation, which when frequently repeated, contributes to swell the volume to rather an enormous size. The same remark applies to the prescriptions, and with redoubled force, since the formula; are copied from the London Pharmacopoeia of 1787? although the new one had appeared some months previous to the publication of Dr. Thornton's book.
1 he doctor has also added the culinary properties, of many vegetables, and has enriched his book with numerous recipes for making wines and other domestic preparations from the various plants he has described, all which cannot fail of being acceptable tp the class of readers for whom his work is principally iniended: &t the same time, it would be injustice to deny, that much \ arable information ) information cm the medical virtues of different substances may be obtained from it by the medical practitioner, who will often sec the result of; extensive experience, and numerous fair trials, accurately and candidly stated under the respective articles.
We give the following extract as arfair specimen of the plan and execution of the work. " COMMON MEADOW SAFFRON. "COLCUICUM AUTUMN ALE. " Ctass VI. Ilexandria. Order III. Tryginia. " EssenT. Gen. Chap.. Corolla six-parted : Tube radical; Capsules con-nected^ inflated. tl Spec Ciiar. Leaves fl it, lanceolate, erect. " Description.?The root is a double succulent bulb. The flower is large, of a purple colour, and tome's directly from the joot. The leaves appear in spring, and are radical, and spears-haped. Corolla consisting of a single petal, divided into six lance-shaped erect segments. Capsule three-lobed, divided into three cells, containing globular seeds, which are not ripened until the succeeding spring, when the capsule rises above the ground upon a strong peduncle.
"History.? Meadow saffron is a perennial bulbous-rooted plant, which grows in wet meadows in the temperate countries of Elurope. It flowers in the beginning of autumn, at which time the old bulb begins to decay, and a new bulb to be formed. In the following May the new bulb is perfected, and the old one wasted and corrugated. They are dug for medical use in the beginning of summer. The sensible qualities of the fresh root are very various, according to the place of growth, and season of the year.
In autumn it is inert; in the beginning of summer, highly acrid some have found it to be a corrosive poison ; others say they have eaten it in considerable quantity without experiencing any effect.
When it is possessed of acrimony, this is of the same nature with that of garlic, and is entire4y destroyed by drying. " Medical Virtues.?Stoerck, Collin, and Plenk, have Celebrated its virtues as a diuretic in hydrothorax and other dropsies. Hut it is at best a very uncertain remedy. The expressed juice is used in Alsace to destroy vermin in the hair. " From various observations on the effects of colchicum made by tax-on Stoprck, ai d ^specially upon the infusion of three grains of the fresh root in tour ounces of wine, he remarked that its diuretic power was very considerable, and therefore concluded, that if its deleterious acrimony were destroyed, it might prove in this cha;ractej-an-efficacious medicine: accordingly, he digested an ounce of the recent root, sliced in a pound of vinegar for forty-eight Iiours with a gentle heat; the vinegar being then strained, it proved acrid to the taste, constrmged and irritated the fauces, and excited' a slight cough ; to obviate which, he mixed the vinegar with twice its. weight of honey, and gdntly boiled it down to the consistence of honey, forming a'ti' oxyniel sufficiently grateful; and which, Dr. Thornton's Family Herbal.
4&7which, taken in. doses of a drachm, promoted a copious discharge of urine, without producing any inconvenience from its acrimony,, though it moderately stimulated the fauces, and absteiged the mucus.
Thus, like the squill, it was found both expectorant and diuretic; and the successful use of this medicine, in various'hydropic disorders in the hospital at Vienna,, equalled the baron's utmost expectations. He recommends, at first, a drachm of the oxymel to be given twice a" day in any suitable vehicle, and gradually to increase the dose to an ounce or more in a day. Many other practitioners, who employed the oxymel colchici In these, complaints, also experienced its good effects, especially in Germany and France, where it continues to be a favourite medicinein England, however, the colchicum lias been less successful, and is very generally thought a less efficacious diuretic thaai the squill, which excels it still more as an expectorant. The London College,,, conformably to the practice of Stoercjc., directs an oxymel colchici* and that of Edinburgh a syrupy the latter, however,, differs from., the former only in using sugar instead of hoijey. vinegar, sixteen ounces-r double refined sugar, twenty-six ounces; Macerate the root in the vinegar two days, occasionally shaking the vessel ; then strain the infusion with gentle expression. Tothe strained infusion add the sugar, and boil a little, so as to form a syrup.
This syrup seems to be the best preparation of the colchicum. We must take carc to gather thisroot in the proper season; and from [to] errors in this particular we are to ascribe the uncertainty in the effects of thjs medicine as found in the shops. Jt is chiefly employed as a diuretic, and may be taken from a drachm or two to the extent of an ounce, or more. * " Oxymel of Meadow Saffron. (Oxymel Colchici. L. D.) " Take of the fresh root of meadow saffron, cut Into thin slices, one ounce; distilled vinegar, one pint; clarified hopey, 4 wo pounds by weight. Macerate the root of meadow saffron with the-vinegar in a glass vessel, with a gentle heat, for forty-eight hours. Strain the liquor, pressed out strongly from the root, and add the honey. Lastly, boil the mixture, frequently stirring it with a \yooden spoon, to the thickness of a syrup. This is an active preparation, but its use may be entirely superseded by the syrup of the same root.
The dose given is a drachm to halt an ounce." Every plant described is accompanied by an engraving; these, as may be expected, in so numerous a list, are of unequal valuer some ve.y accurately representing the plant for which it is designed, and others being not quite so fortunate. The articles follow according to their botanical arrangement, and the want of an index is much felt, tor he who wishes to sre the description of any paticular plant, and is unacquainted with its class and order, has no> oxhor other resource but the running title to guide him in his search; this is certainly no small inconveniencc in consulting a bulky volume like the present one. It is not our intention to search for and detail little errors and inaccuracies, for such must occur in every book of Considerable size, but we certainly were a little surprised by the'Doctor's , remark, (p. 20.) that Turner's Cerate received its appellation because it is used in curing the icqunds of turners; we had always thought it derived its name from the Inventor, who first recommended it as possessing very healing qualities, on which account it'was adopted by the London College, under the title of Ceratum Epouloticum.

429
Xvhere the gastric juice is retained in the apparatus which secreted it, and thus we shall be enabled to explain some cases, which, at present, seem to be in opposition to the observations of Mr.

Hunter."
The author states some points, in difference between Dr. Adams and himself, upon this subject, who, he imagines, has mis-appreliended Mr. Hunter's opinion as to the state of previous health or disease, in which this erosion of the stomach could take place. It >s superfluous for us to enter into this question, we shall refer our readers to a paper contained in a former part of this number, wherein Dr. Adams has entered pretty fully into the merits of it, and defended the statement he had given of Mr. Hunter's opinions. We shall only observe in conclusion, that we do not exactly coincide with the author in opinion, that " poison has been called in to account for the appearance; and thus the life of the person supposed to have administered the deleterious substance might, it is evident, be brought into danger." We think there is not any medical practitioner, who would in a judicial investigation, attribute erosion' of the coats of the Stomach to poison, unless it was accompanied by evident marks of previous inflammation, or with gangrenous appearances; perhaps, in such serious circumstances, he would not positively affirm it without discovering some of the deleterious substance among the contents of that viscus. . Article 2.?Regulations with regard to the passing of Conscripts for the French Army. Extracted from the Code de la Conscription. In Fiance, there is not that discretionary power vested in the military surgeons, which exists in this country, of determining on the ability or disability for duty of individuals liable to military service; the regulations on this head, enacted by the government, are minute, and the execution of them are entrusted to the municipal and central administrations, who are to decide on the validity , of the surgeon's opinions, and even the examinations of the conscript, are to be made in the presence of the administration, or if the conscript is unable to attend the Board, in that of a delegate from it. " Officers of health, and others convicted of having given a false certificate of infirmities or inabilities, or of having received presents or gratifications, shall be punished by not less than one, or more than two years imprisonment, or by fine, not less than 300, or more than 1000 francs." The regulations by which the officers are to be governed in their , ?pinions, are contained in two tables; the first, contains a list of " evident infirmities, implying absolute incapability;" the seCond is entitled " infirmities or diseases which occasion absolute or rela^ tive incapability for military service, and which are reserved for the examination and opinion of the central administrations of the department." Some of these infirmities, only entitle to a provisional exemption, and every care seems taken to guard against abuses of indulgence.
The 4.<iO The Edinburgh Journal.
The following passage will convey an idea of the rigid rules which are observed in the examination of conscripts. 44 We know that young people in the country are more subject to those affections, (rheumatic) than those in towns, and that in some kind of abodes, they are more easily contracted. Joining all these data, combining and comparing them together, the surgeons may commonly distinguish a real affection from a feigned one. As it is but just that, in some other equivocal cases, such as those respect-, ing the diseases of the breast, humanity should incline to the conscript's side; so, with respect to pains and rheumatisms, which are not proven, it is equally proper to prefer severity to indulgence, as military exercise, far from aggravating this predisposition, if it exists, will only contribute to remove it. Communicated by Dr. Chisholm. In a former Journal, p. 166, we gave an account of a paper on the Lues Bovilla, by Dr. Chisholm, to which this may be considered as a supplement. It consists of certain questions, addressed by him to Dr. Florman. Professor of Anatomy in the University of Lund, in v Sweden, together with the Professor's Answers. Dr. Florman himself has never seen this disease, it not having occurred in Sweden sincc the year 1?66\ nor in Denmark since 1772 ; 4*4;, when the cynanchc maligna raged at Grenada in 17S3, -fox JDc. C.
does not fail to remark its concomitancy with a contagious distemper epidemic among the cattle and mules in the same parts of the island where the c\nunche maligna appeared.
"VV'e subjoin the following quotation on the subject, of the resemblance of the pestis bovilla with the small-pox. " Q. 5th. Are there any good reasons for believing, that the. A lady of 25, actid ntally swallowed a skein of cotton ; no incon-, venience was felt for three months, when upon being electrified, she was seized with violent pain in the stomach, without sickness ; the pain returned every day for some months. From a fiiend's only requiring her to take food, says the author, she became sick, and voraitted the cotton, which, from being white, had acquired a permanent green colour, but was little changed in texture; much general indisposition remained for seven or,eight months, but she afterwards enjoyed good health.
Then follows a diary of the symptoms and mode of treatqient of a case of constipation, in which we can trace. no connexion with the skein of cotton that had been previously swallowed, but in which, we clearly perceive the beneficial effects of the purgative plan of treatment carried to some extent, as recommended by Dr. Hamilton. " May 17. The bowels were relieved in the night of the 1.5th and yesterday morning, of hardened faeces to a prodigious amount." Blister after blister was applied to the stomach, and. small doses of calomel (that modern panacea) with hyoscyamus, were given in pills; it Was only, however, by repeated purgatives, that relief was afforded and amendment produced. " 23d, a senna, mixture was substituted for the pills." " 25th, did not begin the mixture till noon yesterday. She has had three copious eyacua.
lions, the first.extremely offensive. This operation hjts producedi considerable amendment." It is unnecessary to detail the remainder of the case, as it cousists of similar reports; amendment when the bowels were kept free,' and, as might be expected, aggravation of the symptoms when this was at any time ncglccted.
Article '43& The Edinburgh Journal.
Article 5,?On the Treatment of Ganglia by Escharotics. By James Woodha'm. " Ganglia, says the author, though not frequent, are far from being uncommon; and as they always prove inconvenient to the patient, and sometimes troublesome to the surgeon, under the , means usually employed for their removal, the annexed cases,' treated successfully by a mode somewhat novel, will not, I trust, be unacceptable to the profession." Two cases are given, in which the treatment consists in applying a blister to the tumour, removing the detached cuticle, and plentifully sprinkling the cutis with the oxyd of arsenic in powder, and repeating this every day, till a complete eschar was formed. To. procure a separation of the eschar, aiid to remove the inflammation that had been excited, an emollient poultice was applied morning and evening. In ten da^s the eschar was completely formed, in a fortnight it was thrown off, leaving a healthy ulcer the size of a shilling, which \vas daily dressed with an ointment of wax and oil, occasionally sprinkling it with nitric oxyd of quicksilver. The whole process of cure took up in each case, something less than three months. Article 6\?Observations upon Ulcers of the Leg. By John" Webb, Surgeon. The author has in this paper presented to us some observations, with an attempt to explain the principle which should be kept in ?view in the treatment of the irritable ulcer. The worst cases, he says, which have come under his care, have been attended with the following character: " the constitution is affected with debility; the digestive powers are impaired ; the function of the liver is diseased ; the circulation is hurried; an anxious watchfulness is depicted upon the countenance; and, from the general irritability which pervades the whole constitution, the patient is seldom relieved by the soothing tranquillity of sleep." His peculiar treatment we shall give in his own words. " The motives which induced me to depart from the regular routine of practice, were from a case where every known application bad been tried, without procuring the wished for effect. Here the constitution was greatly disordered. In this case, the applications ?which alleviated the sufferings of the patient most; were fomentations and poulticcs. Seeing the sufferings of the patient were quelled for a certain time, I was led to consider why the poultice should act thus beneficially for a time, and no longer, aii 1 this whether the application was warm or cold. The conclusions which I drew, were, that the secreted pus must act as an irritating cause, and the patient was easy as long as the poultice absorbed the secreted pus, and kept the surface of the sore clean, and not from the -edative effect of the application, as is generally supposed. The next visit, I dressed the ulcer with two folds of dry lint, over which linen was to be kept wet, with an'evaporating lotion, to allay the surrounding inflammation,, inflammation, and keep the edges of the lint from adhering to the sides of the ulcer, which was to be removed immediately when the patient experienced any pain, and fresh dressings to be substituted. The success which attended this practice, surpassed my most sanguine expectations. In the short space of ten days, an immense chasm was filled with strong healthy granulations; the edges under this treatment were kindly cicatrizing; a diseased constitution was rapidly restored." ( To be Continued. )